Alaitz Corominas saved by world-first lung surgery while she was still in her mother"s WOMB

The happy and healthy toddler whose life was saved by world-first lung surgery while she was still in her mother's WOMB

PUBLISHED:

11:03 GMT, 14 March 2012

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UPDATED:

19:07 GMT, 14 March 2012

A baby’s life was saved by pioneering surgery after doctors carried out an operation on her lungs while she was still in her mother’s womb.

Alaitz Corominas, from Spain, is now a happy and healthy toddler after becoming the world’s first foetus to undergo the procedure three months before she was due to be born.

The 16-month-old girl, who weighed just 1lb 10oz at the time, had only a 10 per cent chance of survival if surgeons in Barcelona had not fixed her blocked bronchial tubes.

Monica and Marcos Corominas with their 16-month-old daughter Alaitz whose life was saved by pioneering neonatal surgery while still in her mother's womb six months into pregnancy

Thanks: Alaitz and her parents pose with her doctors (left to right) Julio Moreno, Josep Martinez, Montserrat Castanon and Eduard Gratacos at the Hospital Clinic in Barcelona

Experts inserted an endoscope – a camera-ended tube that surgical instruments can fit through – into her mouth and then down her windpipe and into her lungs.

An image of her lungs was then beamed on to a giant TV screen in the operating theatre and confirmed that she was suffering from bronchial atresia.

HOW DOCTORS DID IT IN 30 MINUTES

Spanish doctors faced a race against time to fix Alaitz's Corominas's blocked bronchial tubes because her heart
is at risk of filling with liquid during the procedure and it could also force her mother into early labour.

This is how the team in Barcelona did it:

1. Doctors used an ultrasound to guide an endoscope though the mother’s abdomen and into her womb.

2. The endoscope, which has a camera fitted to its end, was then guided through the mouth, down the oesophagus (pictured below) and into the unborn baby’s lungs.

3. Surgeons then reconnected the right-hand-side bronchial tube with the central airways and removed the endesope as quickly – and safely – as possible.

However, because they were reduced to 30 minutes, it meant surgeons could only concentrate on one task.

Thirteen days after Alaitz was born, she underwent an operation to remove two of the three pulmonary lobes of her right lung which were damaged by the malformation of her bronchi.

This where the bronchi – the air tube leading from the trachea to the lungs – do not properly connect with the central airways, meaning breathing is almost impossible.

Surgeons from two institutions – Hospital Clinic and Joan de Deu – reconnected the bronchial tubes on the right lung to her central airways in a procedure lasting just 30 minutes.

‘In such cases, you have to operate quickly, like a bank robbery,’ said Eduard Gratacos, who led the surgery.

However, they had to be extremely delicate because the procedure is carried out near the heart on ‘tissue as thin as cigarette paper’, Dr Graticos added.

To complicate things further, the heart is at risk of filling with liquid and can require restarting. Luckily this did not happen.

At the time of the operation, Alaitz, whose name means ‘Joy’ in her parents' native Basque language, was operated on during her mother’s 26th week – or six-month mark – of pregnancy.

She went on to nearly complete a full nine-month term and was born in November 2010 weighing 5lb 8oz.

Grinning, waving and proudly walking, Alaitz, appeared in public for the first time yesterday along with her parents at a press conference held at the Hospital Clinic.

‘She is completely normal. She wakes up happy, she laughs if she is pleased, she cries if she is hungry,’ he mother, Monica Corominas, 33, said.

‘It was the only option. We either tried it or put an end to the pregnancy.’

Dr Gratacos, the head of the maternal-fetal medicine department at Clinic, told the AFP news agency: ‘It is the first time in the world that this has been achieved.

‘It is the first time that it has been tried and it turned out well.

The expert team of doctors also included Josep Maria Martnez, Montserrat Castan and Julio Moreno.

‘If we hadn’t operated on her, she would have died,’ Dr Moreno, a neonatologist at Sant Joan de Du hospital, told Spain’s El Pais newspaper.

He said Alaitz was now expected to live ‘a completely normal life’.

Beaming: Alaitz smiles as she is photographed during a press conference at the hospital

Proud: The toddler, who is expected to live a full life, shows off her new walking skills to photographers

Doctors discovered a problem with her lungs after a routine ultrasound examination to check the baby’s health.

They decided to act swiftly because the likelihood of her surviving without an immediate operation was so slim.

But while the Hospital Clinica is one of the top five centres in the world for foetal surgery, such a procedure on her lungs was particularly risky and had never successfully been carried out before.

Usually, prenatal operations are carried out on unborn babies with hernias and heart conditions.

Even in the U.S., where these surgeries are most common, only 600 babies a year are typically operated on and are often not successful.

Prenatal surgery is similar to other operations, except that the foetus remains dependent on the placenta.

Mother's pride: Alaitz, which means joy in her parents' native Basque language, looks up to Monica

At least they're happy: Alaitz pulls a frown while her parents smile for the cameras

After 30 weeks, doctors prefer to operate on the baby outside of the uterus as it is less complicated.

But Alaitz’s case, she was too young to be removed and would be is unlilely to have survived on the outside, even if they had operated on her lungs.

One of the main dangers is the risk of triggering early labour. This is why the task had to be carried out so quickly.

However, it means that surgeons can only concentrate on one task and often means that other problems cannot be dealt with.

Thirteen days after Alaitz was born, she underwent an operation to remove two of the three pulmonary lobes of her right lung which were damaged by the malformation of her bronchi.

Doctors said their removal will not affect her health and quality of life.